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DM Malignancy Screening Duration — RACP Adult Medicine MCQ

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HardRheumatologyDM Malignancy Screening DurationRACP Adult Medicine

A 55-year-old has newly diagnosed dermatomyositis with dysphagia, anti-TIF1-gamma antibodies and no malignancy on initial age-appropriate and enhanced screening. What follow-up principle is most appropriate?

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Correct answer: B — Continue risk-stratified malignancy surveillance during the first three years after symptom onset

The best answer is “Continue risk-stratified malignancy surveillance during the first three years after symptom onset”. Cancer risk in adult-onset inflammatory myopathy is concentrated around onset, and anti-TIF1-gamma positivity plus dysphagia increase risk. International myositis guidance supports enhanced screening at diagnosis and ongoing risk-stratified follow-up over the first three years. Indefinite PET, isolated tumour markers or a single negative scan either overtest or under-detect.

Reference: American College of Rheumatology: Treatment of interstitial lung disease in systemic autoimmune rheumatic diseases: https://rheumatology.org/interstitial-lung-disease-guideline Cancer Council Australia: Cancer screening: https://www.cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening